Aim: To present our experience of surgical management of vesicovaginal fistulas (VVFs).
Materials and methods: From 1996 to 2025, 156 women with VVFs underwent surgical treatment at the Department of Urology, North-Western State Medical University named after I.I. Mechnikov. Age ranged from 21 to 79 years (mean 45.2+/-4.6 years). Recurrent fistulas were observed in 42 (26.9%) patients, who had previously undergone from one to six unsuccessful surgical attempts. The predominant cause of VVF formation was iatrogenic injury to the urinary bladder during gynecological interventions (77.5%). Fistula repair was performed in 140 patients, with a transvaginal approach used in 91.4% of cases. The transabdominal approach was employed in 12 women, including 10 cases with concurrent ureteral reconstruction and 2 performed via laparoscopic approach.
Results: Among 140 patients who underwent fistula closure, success was achieved in 139 cases (99.3%).
Discussion: In our clinic, transvaginal fistula closure is the preferred surgical method for managing vesicovaginal fistulas. We consider it the least traumatic open technique, even compared with its laparoscopic alternative.
Conclusion: Transvaginal vesicovaginal fistula closure remains the method of choice for treatment of VVFs. A transabdominal approach, including laparoscopic repair, is justified only when simultaneous ureteral reconstruction is required. Heterotopic cystoplasty is regarded as the most reliable reconstructive option for patients with radiation-induced fistulas.
{"title":"[Vesicovaginal fistulas: surgical strategy and rare clinical observations].","authors":"K Komyakov B","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To present our experience of surgical management of vesicovaginal fistulas (VVFs).</p><p><strong>Materials and methods: </strong>From 1996 to 2025, 156 women with VVFs underwent surgical treatment at the Department of Urology, North-Western State Medical University named after I.I. Mechnikov. Age ranged from 21 to 79 years (mean 45.2+/-4.6 years). Recurrent fistulas were observed in 42 (26.9%) patients, who had previously undergone from one to six unsuccessful surgical attempts. The predominant cause of VVF formation was iatrogenic injury to the urinary bladder during gynecological interventions (77.5%). Fistula repair was performed in 140 patients, with a transvaginal approach used in 91.4% of cases. The transabdominal approach was employed in 12 women, including 10 cases with concurrent ureteral reconstruction and 2 performed via laparoscopic approach.</p><p><strong>Results: </strong>Among 140 patients who underwent fistula closure, success was achieved in 139 cases (99.3%).</p><p><strong>Discussion: </strong>In our clinic, transvaginal fistula closure is the preferred surgical method for managing vesicovaginal fistulas. We consider it the least traumatic open technique, even compared with its laparoscopic alternative.</p><p><strong>Conclusion: </strong>Transvaginal vesicovaginal fistula closure remains the method of choice for treatment of VVFs. A transabdominal approach, including laparoscopic repair, is justified only when simultaneous ureteral reconstruction is required. Heterotopic cystoplasty is regarded as the most reliable reconstructive option for patients with radiation-induced fistulas.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 5","pages":"113-119"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Introduction: </strong>The first part of a systematic review and meta-analysis addressing the problem of purulent pyelonephritis is presented in the article.</p><p><strong>Aim: </strong>To analyze the epidemiology, predisposing factors, diagnostic approaches, and microbiological characteristics of purulent pyelonephritis, which is a complicated form of acute pyelonephritis characterized by renal parenchymal suppuration, sepsis, or localized abscess.</p><p><strong>Materials and methods: </strong>A systematic review of 46 studies (1981-2024) on complicated pyelonephritis was performed. The review included clinical series (observational and one randomized trial) with more or equal 10 patients reporting on prevalence, risk factors, clinical course, diagnostic approaches, microbiology, treatment, and outcomes of severe pyelonephritis. Data were synthesized qualitatively, and a meta-analysis of key outcomes (mortality and need for surgical intervention) was carried out using a random-effects model.</p><p><strong>Results: </strong>Acute pyelonephritis is one of the most common serious urinary tract infections, with an annual incidence of 15-17 per 10,000 women and 3-5 per 10,000 men. In most cases, the disease responds well to antibiotic therapy; however, in 20-30% of patients complicated pyelonephritis develops. Predisposing factors include diabetes mellitus, urinary tract obstruction, advanced age, male sex, immunodeficiency, and pregnancy. Diabetes mellitus is present in 30-35% of hospitalized patients with pyelonephritis (vs. 10-15% in uncomplicated cases) and in 75-95% of patients with emphysematous pyelonephritis. Urolithiasis accounts for approximately 20% of cases with complicated pyelonephritis. Elderly (>65 years) and male patients are affected less frequently but experience more severe disease: men constitute only about 25% of acute pyelonephritis cases but have higher rates of abscess and sepsis. Purulent pyelonephritis is typically associated with pronounced systemic symptoms: high fever (>39 C in 70% of cases), chills (50-60%), and septic shock (25-30% upon admission). In 15-20% of severe cases, local urinary symptoms (flank pain, dysuria) are absent. Laboratory findings usually demonstrate leukocytosis >15109/L (80%) or, conversely, leukopenia <4109/L (20-30%) in cases with disseminated intravascular coagulation, along with markedly elevated C-reactive protein levels (>100 mg/L). Imaging plays a decisive role: ultrasound can detect hydronephrosis and pyonephrosis, whereas contrast-enhanced computed tomography is the gold standard for detecting abscesses and gas formation. The main pathogens of complicated pyelonephritis are Gram-negative enteric bacteria, primarily Escherichia coli (60-75%), Klebsiella pneumoniae (10-15%), and Proteus mirabilis (5-10%). In 10-30% of cases, isolates exhibit multidrug resistance (e.g., ESBL-producing strains). Polymicrobial infection occurs in approximately 5-10% of severe cases.</p><p><strong>Co
{"title":"[Epidemiology, risk factors, diagnosis, and microbiology of suppurative pyelonephritis: a systematic review and meta-analysis, part 1].","authors":"N Pavlov V, A Vorobyev V, A Ananyev V","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The first part of a systematic review and meta-analysis addressing the problem of purulent pyelonephritis is presented in the article.</p><p><strong>Aim: </strong>To analyze the epidemiology, predisposing factors, diagnostic approaches, and microbiological characteristics of purulent pyelonephritis, which is a complicated form of acute pyelonephritis characterized by renal parenchymal suppuration, sepsis, or localized abscess.</p><p><strong>Materials and methods: </strong>A systematic review of 46 studies (1981-2024) on complicated pyelonephritis was performed. The review included clinical series (observational and one randomized trial) with more or equal 10 patients reporting on prevalence, risk factors, clinical course, diagnostic approaches, microbiology, treatment, and outcomes of severe pyelonephritis. Data were synthesized qualitatively, and a meta-analysis of key outcomes (mortality and need for surgical intervention) was carried out using a random-effects model.</p><p><strong>Results: </strong>Acute pyelonephritis is one of the most common serious urinary tract infections, with an annual incidence of 15-17 per 10,000 women and 3-5 per 10,000 men. In most cases, the disease responds well to antibiotic therapy; however, in 20-30% of patients complicated pyelonephritis develops. Predisposing factors include diabetes mellitus, urinary tract obstruction, advanced age, male sex, immunodeficiency, and pregnancy. Diabetes mellitus is present in 30-35% of hospitalized patients with pyelonephritis (vs. 10-15% in uncomplicated cases) and in 75-95% of patients with emphysematous pyelonephritis. Urolithiasis accounts for approximately 20% of cases with complicated pyelonephritis. Elderly (>65 years) and male patients are affected less frequently but experience more severe disease: men constitute only about 25% of acute pyelonephritis cases but have higher rates of abscess and sepsis. Purulent pyelonephritis is typically associated with pronounced systemic symptoms: high fever (>39 C in 70% of cases), chills (50-60%), and septic shock (25-30% upon admission). In 15-20% of severe cases, local urinary symptoms (flank pain, dysuria) are absent. Laboratory findings usually demonstrate leukocytosis >15109/L (80%) or, conversely, leukopenia <4109/L (20-30%) in cases with disseminated intravascular coagulation, along with markedly elevated C-reactive protein levels (>100 mg/L). Imaging plays a decisive role: ultrasound can detect hydronephrosis and pyonephrosis, whereas contrast-enhanced computed tomography is the gold standard for detecting abscesses and gas formation. The main pathogens of complicated pyelonephritis are Gram-negative enteric bacteria, primarily Escherichia coli (60-75%), Klebsiella pneumoniae (10-15%), and Proteus mirabilis (5-10%). In 10-30% of cases, isolates exhibit multidrug resistance (e.g., ESBL-producing strains). Polymicrobial infection occurs in approximately 5-10% of severe cases.</p><p><strong>Co","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 5","pages":"151-160"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N Pavlov V, E Baykov D, S Kagarmanova A, F Itkulov A
The occurrence of acute kidney damage associated with the introduction of an iodine-containing contrast agent into the vascular bed, which leads to transient or persistent structural and functional changes in nephrons, endothelial cells, and renal tubule epithelium, is an urgent problem in modern instrumental diagnostics of various pathological processes, since iodine-containing preparations have a strong advantage over "native" scanning. A researcher who uses different techniques depending on the tasks set opens up great prospects in studying many aspects of the structure and function of tissues. New technologies are being actively introduced into clinical practice, with the possibility of selective visualization of small visceral vessels not only using subtractive angiography, but also selective CT angiography/venography. In foreign and domestic literature, the main emphasis is placed on the development of acute kidney damage when using iodine-containing contrast agents in "compromised" patients with chronic structural disorders in the kidneys, with evidence that the risks of acute damage are high in chronic renal failure. As for acute disorders - in some cases with complicated forms of pyelonephritis, life-threatening situations, CT with contrast enhancement and alternative methods of selectiveangiographyand renal arteries in combination treatmentis extremely necessary.
{"title":"[Risks of acute kidney injury with intravascular administration of an iodine-containing contrast agent in patients with acute pyelonephritis].","authors":"N Pavlov V, E Baykov D, S Kagarmanova A, F Itkulov A","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The occurrence of acute kidney damage associated with the introduction of an iodine-containing contrast agent into the vascular bed, which leads to transient or persistent structural and functional changes in nephrons, endothelial cells, and renal tubule epithelium, is an urgent problem in modern instrumental diagnostics of various pathological processes, since iodine-containing preparations have a strong advantage over \"native\" scanning. A researcher who uses different techniques depending on the tasks set opens up great prospects in studying many aspects of the structure and function of tissues. New technologies are being actively introduced into clinical practice, with the possibility of selective visualization of small visceral vessels not only using subtractive angiography, but also selective CT angiography/venography. In foreign and domestic literature, the main emphasis is placed on the development of acute kidney damage when using iodine-containing contrast agents in \"compromised\" patients with chronic structural disorders in the kidneys, with evidence that the risks of acute damage are high in chronic renal failure. As for acute disorders - in some cases with complicated forms of pyelonephritis, life-threatening situations, CT with contrast enhancement and alternative methods of selectiveangiographyand renal arteries in combination treatmentis extremely necessary.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 5","pages":"137-143"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B Loran O, A Vorobev V, V Kosova I, R Kasyan G, K Sharakshinov B, O Kostyuchenko D
Objective: To evaluate the efficacy and safety of surgical approaches for recurrent postcoital cystitis (PCC) in women.
Materials and methods: A systematic search (PubMed, Scopus, Web of Science, eLibrary) was conducted following PRISMA 2020 guidelines. Nine studies (n=1850) were included, assessing surgical treatment of PCC in women more or equal 18 years. Interventions included extravaginal urethral transposition, distal transposition, hymenoplasty, urethro-vaginal adhesiolysis with bulking injection, and urethroplasty.
Outcomes: recurrence rates, treatment success, quality of life, and complications.
Results: The average success rate of surgical treatment was 87.7% (95% CI 80-92%), significantly higher than that of conservative approaches (10%). Extravaginal urethral transposition demonstrated the highest results (93% success rate, up to 77.9% complete absence of recurrence). Hymenoplasty and combined minimally invasive techniques provided 84-91% success rates but more frequently required repeat interventions. Complication rates were low (0-5%), mostly transient. Improved quality of life and sexual function were noted in 90% of patients.
Conclusion: Surgical treatment of PCC leads to a significant reduction in infection recurrence and improved quality of life in appropriately selected patients. However, the overall evidence base on this topic is limited: there are no randomized trials, the quality of existing studies is low, and sample sizes are small. Data on long-term efficacy, complications, and causes of treatment failure are virtually nonexistent. These limitations prevent a definitive recommendation for surgical correction as a treatment of choice for a wide range of patients. The obtained results should be interpreted with caution, and further prospective and controlled studies are needed to confirm the advantages of the surgical approach and develop clear indications.
目的：评价手术入路治疗复发性阴道后膀胱炎（PCC）的有效性和安全性。材料和方法：根据PRISMA 2020指南进行系统检索（PubMed, Scopus, Web of Science, library）。纳入9项研究（n=1850），评估18岁以上女性PCC的手术治疗。干预措施包括尿道末端移位、远端移位、处女膜成形术、尿道阴道粘连松解术和尿道成形术。结果：复发率、治疗成功率、生活质量和并发症。结果：手术治疗平均成功率为87.7% (95% CI 80 ~ 92%)，明显高于保守入路（10%）。经尿道转位的成功率最高（93%，77.9%完全无复发）。处女膜成形术联合微创技术的成功率为84-91%，但更频繁地需要重复干预。并发症发生率低（0-5%），大多是短暂的。90%的患者生活质量和性功能得到改善。结论：手术治疗PCC可显著降低感染复发率，改善患者的生活质量。然而，关于这一主题的整体证据基础是有限的：没有随机试验，现有研究的质量很低，样本量很小。关于长期疗效、并发症和治疗失败原因的数据几乎不存在。这些限制阻碍了外科矫正作为广泛患者的治疗选择的明确推荐。所获得的结果应谨慎解释，需要进一步的前瞻性和对照研究来确认手术入路的优势并制定明确的适应症。
{"title":"[Outcomes of Surgical Correction of the Urethra in the Management of Postcoital Cystitis: A Systematic Review and Meta-Analysis].","authors":"B Loran O, A Vorobev V, V Kosova I, R Kasyan G, K Sharakshinov B, O Kostyuchenko D","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of surgical approaches for recurrent postcoital cystitis (PCC) in women.</p><p><strong>Materials and methods: </strong>A systematic search (PubMed, Scopus, Web of Science, eLibrary) was conducted following PRISMA 2020 guidelines. Nine studies (n=1850) were included, assessing surgical treatment of PCC in women more or equal 18 years. Interventions included extravaginal urethral transposition, distal transposition, hymenoplasty, urethro-vaginal adhesiolysis with bulking injection, and urethroplasty.</p><p><strong>Outcomes: </strong>recurrence rates, treatment success, quality of life, and complications.</p><p><strong>Results: </strong>The average success rate of surgical treatment was 87.7% (95% CI 80-92%), significantly higher than that of conservative approaches (10%). Extravaginal urethral transposition demonstrated the highest results (93% success rate, up to 77.9% complete absence of recurrence). Hymenoplasty and combined minimally invasive techniques provided 84-91% success rates but more frequently required repeat interventions. Complication rates were low (0-5%), mostly transient. Improved quality of life and sexual function were noted in 90% of patients.</p><p><strong>Conclusion: </strong>Surgical treatment of PCC leads to a significant reduction in infection recurrence and improved quality of life in appropriately selected patients. However, the overall evidence base on this topic is limited: there are no randomized trials, the quality of existing studies is low, and sample sizes are small. Data on long-term efficacy, complications, and causes of treatment failure are virtually nonexistent. These limitations prevent a definitive recommendation for surgical correction as a treatment of choice for a wide range of patients. The obtained results should be interpreted with caution, and further prospective and controlled studies are needed to confirm the advantages of the surgical approach and develop clear indications.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 5","pages":"183-197"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V Polukonova N, N Fomkin R, E Pylaev T, B Bucharskaya A, G Mezirov G, S Voronina E, M Popkov V, A Fomkina O, E Krupinov G
Objective: The aim of the study was to analyze genomic combinations of four SNPs-rs4430796 (HNF1B), rs1859962 (CASC17), rs1447295 (CASC8), and rs6983267 (CCAT2) - associated with prostate cancer (PCa) in urological patients, including those with benign prostatic hyperplasia (BPH), PCa, and urolithiasis (UL).
Materials and methods: A genetic study of blood samples from 236 patients in the Russian population was conducted, including 97 with benign prostatic hyperplasia (BPH), 89 with prostate cancer (PC) and 50 with urolithiasis (UL) - the control group. The extraction of DNA from venous blood was undertaken, and genotyping was subsequently performed by PCR followed by restriction degradation. Subsequently, the allele and genotype frequencies were compared between groups using the test. Odds ratios (OR) and 95% confidence intervals were estimated. The results obtained from this study are as follows. An association was identified between mutant alleles T (HNF1B) and C (CASC17) in RP and BPH, which was absent in the control group. The TT genotype at rs4430796 (HNF1B) has been demonstrated to be associated with an increased risk of prostate cancer (OR=2,38; 95% CI: 1,26-4,47; p=0,004). The CC genotype at rs1859962 (CASC17) has also been demonstrated to be associated with prostate cancer (OR=3,80; 95% CI: 1,30-11,4; p=0,015). The TT (HNF1B) + CC (CASC17) combination was absent in patients with ICD, but was common in patients with RP and DGP. It is also considered a possible marker of the tumour process. The area under the curve (AUC) was 0,71, which corresponds to moderate diagnostic value. The genomic combinations GG TT (CASC8+CCAT2) and GG G/T exhibited differences between the DGP and RP groups. The study identified unique combinations of four single-nucleotide polymorphisms (SNPs) that are characteristic of patients with DGP.
Conclusion: A combined analysis of polymorphisms rs4430796 and rs1859962 has the potential to serve as a basis for the genetic stratification of PR risk in the Russian population. The identified genomic combinations have potential as marker panels for screening and differentiation of PC and BPH, as well as for the development of personalised approaches in oncology.
{"title":"[Genetic polymorphisms of HNF1B, CASC17, CASC8 AND CCAT2 genes associated with prostate cancer risk in urologic patients].","authors":"V Polukonova N, N Fomkin R, E Pylaev T, B Bucharskaya A, G Mezirov G, S Voronina E, M Popkov V, A Fomkina O, E Krupinov G","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to analyze genomic combinations of four SNPs-rs4430796 (HNF1B), rs1859962 (CASC17), rs1447295 (CASC8), and rs6983267 (CCAT2) - associated with prostate cancer (PCa) in urological patients, including those with benign prostatic hyperplasia (BPH), PCa, and urolithiasis (UL).</p><p><strong>Materials and methods: </strong>A genetic study of blood samples from 236 patients in the Russian population was conducted, including 97 with benign prostatic hyperplasia (BPH), 89 with prostate cancer (PC) and 50 with urolithiasis (UL) - the control group. The extraction of DNA from venous blood was undertaken, and genotyping was subsequently performed by PCR followed by restriction degradation. Subsequently, the allele and genotype frequencies were compared between groups using the test. Odds ratios (OR) and 95% confidence intervals were estimated. The results obtained from this study are as follows. An association was identified between mutant alleles T (HNF1B) and C (CASC17) in RP and BPH, which was absent in the control group. The TT genotype at rs4430796 (HNF1B) has been demonstrated to be associated with an increased risk of prostate cancer (OR=2,38; 95% CI: 1,26-4,47; p=0,004). The CC genotype at rs1859962 (CASC17) has also been demonstrated to be associated with prostate cancer (OR=3,80; 95% CI: 1,30-11,4; p=0,015). The TT (HNF1B) + CC (CASC17) combination was absent in patients with ICD, but was common in patients with RP and DGP. It is also considered a possible marker of the tumour process. The area under the curve (AUC) was 0,71, which corresponds to moderate diagnostic value. The genomic combinations GG TT (CASC8+CCAT2) and GG G/T exhibited differences between the DGP and RP groups. The study identified unique combinations of four single-nucleotide polymorphisms (SNPs) that are characteristic of patients with DGP.</p><p><strong>Conclusion: </strong>A combined analysis of polymorphisms rs4430796 and rs1859962 has the potential to serve as a basis for the genetic stratification of PR risk in the Russian population. The identified genomic combinations have potential as marker panels for screening and differentiation of PC and BPH, as well as for the development of personalised approaches in oncology.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 5","pages":"44-52"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E Efremov M, L Medvedev V, D Anosov A, P Akopov D, I Kogan M, V Sizyakyn D
<p><strong>Introduction: </strong>Accurate assessment of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH) is one of the key tasks of a urologist for selecting adequate therapy, monitoring treatment, and determining indications for surgical treatment. The International Prostate Symptom Score (IPSS) questionnaire, developed in 1992, has become a simple and widely used method to grade the presence, type, and severity of LUTS in men with BPH. However, the IPSS has certain limitations: the poorer a patients cognitive abilities, the greater the likelihood of incorrect responses due to the complexity and abstract nature of the questions and the difficulty in translating subjective sensations into a written numerical score. In 2011, a new tool, namely the Visual Prostate Symptom Score (VPSS), was proposed as a visual analogue of the IPSS, in which the questions are presented in pictorial form, thereby reducing the dependence on literacy and cognitive function. Despite these advances, the search for the most rational and cognitively accessible questionnaire for assessing LUTS remains relevant.</p><p><strong>Aim: </strong>To compare the IPSS, modified IPSS (mIPSS), and VPSS questionnaires in men with BPH, with reference to uroflowmetry and cognitive function, and to improve the diagnostic accuracy of IPSS through its modification.</p><p><strong>Materials and methods: </strong>A total of 72 men with symptomatic BPH presenting for initial outpatient evaluation were included in the prospective study. The median age was 68 [64-72] years. All patients underwent standard assessments according to the Russian Society of Urology clinical guidelines: urinalysis, complete blood count, prostate-specific antigen (PSA) testing, transrectal ultrasound (TRUS) with measurement of prostate volume and post-void residual urine, renal ultrasonography, and uroflowmetry. Inclusion criteria were: prostate volume 40-180 cc, residual urine less or equal 150 mL, and PSA < 4 ng/mL. Exclusion criteria were suspicion of prostate cancer or other causes of voiding dysfunction unrelated to BPH. All patients provided written informed consent, and the study was approved by the local ethics committee. Each participant completed four questionnaires, including the newly developed modified IPSS (mIPSS). In this version, the IPSS items were divided into two groups: voiding (obstructive) symptoms: questions 1, 3, 5, 6; storage (irritative) symptoms: questions 2, 4, 7.</p><p><strong>Results: </strong>For most questions, the proportion of identical responses between questionnaires exceeded 50%, and all correlation coefficients were r > 0.6, indicating a strong association between the results and suggesting that the tools measure similar constructs and are largely interchangeable. Uroflowmetry parameters correlated significantly only with the total mIPSS score. Both Qmax and Qave showed a significant inverse correlation with mIPSS total score, while voided volu
{"title":"[Prospective comparison of the IPSS, mIPSS and VPSS questionnaires with uroflowmetry and cognitive functions control in men with benign prostatic hyperplasia].","authors":"E Efremov M, L Medvedev V, D Anosov A, P Akopov D, I Kogan M, V Sizyakyn D","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate assessment of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH) is one of the key tasks of a urologist for selecting adequate therapy, monitoring treatment, and determining indications for surgical treatment. The International Prostate Symptom Score (IPSS) questionnaire, developed in 1992, has become a simple and widely used method to grade the presence, type, and severity of LUTS in men with BPH. However, the IPSS has certain limitations: the poorer a patients cognitive abilities, the greater the likelihood of incorrect responses due to the complexity and abstract nature of the questions and the difficulty in translating subjective sensations into a written numerical score. In 2011, a new tool, namely the Visual Prostate Symptom Score (VPSS), was proposed as a visual analogue of the IPSS, in which the questions are presented in pictorial form, thereby reducing the dependence on literacy and cognitive function. Despite these advances, the search for the most rational and cognitively accessible questionnaire for assessing LUTS remains relevant.</p><p><strong>Aim: </strong>To compare the IPSS, modified IPSS (mIPSS), and VPSS questionnaires in men with BPH, with reference to uroflowmetry and cognitive function, and to improve the diagnostic accuracy of IPSS through its modification.</p><p><strong>Materials and methods: </strong>A total of 72 men with symptomatic BPH presenting for initial outpatient evaluation were included in the prospective study. The median age was 68 [64-72] years. All patients underwent standard assessments according to the Russian Society of Urology clinical guidelines: urinalysis, complete blood count, prostate-specific antigen (PSA) testing, transrectal ultrasound (TRUS) with measurement of prostate volume and post-void residual urine, renal ultrasonography, and uroflowmetry. Inclusion criteria were: prostate volume 40-180 cc, residual urine less or equal 150 mL, and PSA < 4 ng/mL. Exclusion criteria were suspicion of prostate cancer or other causes of voiding dysfunction unrelated to BPH. All patients provided written informed consent, and the study was approved by the local ethics committee. Each participant completed four questionnaires, including the newly developed modified IPSS (mIPSS). In this version, the IPSS items were divided into two groups: voiding (obstructive) symptoms: questions 1, 3, 5, 6; storage (irritative) symptoms: questions 2, 4, 7.</p><p><strong>Results: </strong>For most questions, the proportion of identical responses between questionnaires exceeded 50%, and all correlation coefficients were r > 0.6, indicating a strong association between the results and suggesting that the tools measure similar constructs and are largely interchangeable. Uroflowmetry parameters correlated significantly only with the total mIPSS score. Both Qmax and Qave showed a significant inverse correlation with mIPSS total score, while voided volu","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 5","pages":"77-83"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D Kuzmin M, L Kartashova O, A Kapustina O, M Pashkova T, P Popova L, A Gritsenko V
Aim: To analyze genes that determine pathogenicity factors in staphylococcal strains isolated from prostatic secretions in chronic bacterial prostatitis.
Materials and methods: Staphylococci were isolated from the prostate secretion of men of reproductive age (20-45 years) with chronic bacterial prostatitis using a conventional bacteriological method. The type of staphylococci was determined by MALDI-TOF mass spectrometry. The virulence genes of staphylococci were determined by PCR and sequencing.
Results: The isolated strains were found to have a wide distribution of genetic determinants of pathogenicity, namely adhesion, colonization, invasion, and immune resistance. It was shown that most genes are associated with evasion of the host immune response during infection, which contributes to the chronic course of bacterial prostatitis.
Conclusion: It is advisable to further study the genetic determinants of pathogenicity/virulence of Staphylococcus aureus to assess the severity and duration of chronic bacterial prostatitis.
{"title":"[Characteristics of the Pathogenic Potential of Staphylococcus aureus Strains Isolated from Prostatic Secretions in Chronic Bacterial Prostatitis].","authors":"D Kuzmin M, L Kartashova O, A Kapustina O, M Pashkova T, P Popova L, A Gritsenko V","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To analyze genes that determine pathogenicity factors in staphylococcal strains isolated from prostatic secretions in chronic bacterial prostatitis.</p><p><strong>Materials and methods: </strong>Staphylococci were isolated from the prostate secretion of men of reproductive age (20-45 years) with chronic bacterial prostatitis using a conventional bacteriological method. The type of staphylococci was determined by MALDI-TOF mass spectrometry. The virulence genes of staphylococci were determined by PCR and sequencing.</p><p><strong>Results: </strong>The isolated strains were found to have a wide distribution of genetic determinants of pathogenicity, namely adhesion, colonization, invasion, and immune resistance. It was shown that most genes are associated with evasion of the host immune response during infection, which contributes to the chronic course of bacterial prostatitis.</p><p><strong>Conclusion: </strong>It is advisable to further study the genetic determinants of pathogenicity/virulence of Staphylococcus aureus to assess the severity and duration of chronic bacterial prostatitis.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 5","pages":"59-65"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M Andreeva E, V Zakharova A, A Izotova A, O Kryukova N, V Mikhailova L, V Priputnevich T, V Rafalskiy V, P Roitman A, E Shabanova N, V Yakovlev S
Aim: To analyze the structure of pathogens responsible for community-acquired urinary tract infections (UTIs) in the Russian Federation during 2022-2024.
Materials and methods: A total of 566,122 microbiological urine samples from residents of 834 cities across 83 regions of the Russian Federation were analyzed between 2022 and 2024. The study was carried out using real-world data (RWD) analysis, based on relevant segments of the Invitro Laboratory database. Separate analyses were performed for specific types of UTIs in pregnant women, children, men, and women across various age groups.
Results: The most common UTI pathogen in Russia was Escherichia coli, detected in 40.7% of men, 69.5% of women, and 61.2% of children with community-acquired UTIs. The prevalence of E. coli was highest among women aged 38-55 years and men aged 20-50 years. The second most frequent pathogen was Klebsiella pneumoniae (12.8%), with an increasing detection rate beginning from the 38-40-year age group. Among other Enterobacterales, Proteus mirabilis was identified in 3.4% of cases. Among Gram-positive bacteria, the leading pathogens were Enterococcus faecalis (5.7%), Staphylococcus saprophyticus (1.5%), and Streptococcus agalactiae (1.8%). A significant increase in Streptococcus agalactiae detection was observed in pregnant women (6-19%) compared with non-pregnant women (2-5%) of the same age group.
Conclusions: RWD analysis represents a simple and cost-effective tool for studying the pathogen structure of community-acquired UTIs. It complements traditional microbiological surveillance methods and provides unique insights into infection etiology, including detection rates of less common uropathogens and detailed age-related variations in pathogen distribution.
{"title":"[Structure of community-acquired urinary tract infection pathogens in the Russian Federation in 20222024: results of the RESOURCE-2 study].","authors":"M Andreeva E, V Zakharova A, A Izotova A, O Kryukova N, V Mikhailova L, V Priputnevich T, V Rafalskiy V, P Roitman A, E Shabanova N, V Yakovlev S","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To analyze the structure of pathogens responsible for community-acquired urinary tract infections (UTIs) in the Russian Federation during 2022-2024.</p><p><strong>Materials and methods: </strong>A total of 566,122 microbiological urine samples from residents of 834 cities across 83 regions of the Russian Federation were analyzed between 2022 and 2024. The study was carried out using real-world data (RWD) analysis, based on relevant segments of the Invitro Laboratory database. Separate analyses were performed for specific types of UTIs in pregnant women, children, men, and women across various age groups.</p><p><strong>Results: </strong>The most common UTI pathogen in Russia was Escherichia coli, detected in 40.7% of men, 69.5% of women, and 61.2% of children with community-acquired UTIs. The prevalence of E. coli was highest among women aged 38-55 years and men aged 20-50 years. The second most frequent pathogen was Klebsiella pneumoniae (12.8%), with an increasing detection rate beginning from the 38-40-year age group. Among other Enterobacterales, Proteus mirabilis was identified in 3.4% of cases. Among Gram-positive bacteria, the leading pathogens were Enterococcus faecalis (5.7%), Staphylococcus saprophyticus (1.5%), and Streptococcus agalactiae (1.8%). A significant increase in Streptococcus agalactiae detection was observed in pregnant women (6-19%) compared with non-pregnant women (2-5%) of the same age group.</p><p><strong>Conclusions: </strong>RWD analysis represents a simple and cost-effective tool for studying the pathogen structure of community-acquired UTIs. It complements traditional microbiological surveillance methods and provides unique insights into infection etiology, including detection rates of less common uropathogens and detailed age-related variations in pathogen distribution.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 5","pages":"5-17"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Chronic bacterial prostatitis (CBP) is a disease with a multifaceted pathophysiological basis, including infectious, immunological, neurological, vascular, endocrinological, biochemical, and psychological factors, making it a multidisciplinary problem. One current treatment strategy is the use of the original drug Longidaza, which has demonstrated efficacy in this disease, primarily due to its anti-inflammatory effect. A large number of original studies necessitate systematization of the results.
Objective: To conduct a comprehensive assessment of the clinical efficacy of Longidaza (bovhyaluronidase azoximer) when included in the treatment plan for chronic prostatitis, based on data from controlled clinical trials.
Materials and methods: A systematic review and meta-analysis were conducted according to the PRISMA protocol. Elibrary, PubMed, and Cyberleninka databases were used to search for articles. The search was conducted using a combination of keywords: chronic prostatitis and "Longidaza," "Bovhyaluronidase azoximer," among studies published no later than August 31, 2025.
Results: A search of scientific databases using the algorithms illustrated in Figure 1 yielded a total of 210 publications, of which 10 studies were then selected based on inclusion/exclusion criteria.
Conclusions: The results of the analysis suggest that adding Longidaza to standard therapy for chronic prostatitis (antimicrobial and anti-inflammatory agents) significantly reduces clinical manifestations of the disease. Furthermore, the inclusion of Longidaza in the treatment plan reduces inflammation in the prostate gland and improves maximum urinary flow rate, resulting in a significant reduction in the severity of chronic prostatitis.
{"title":"[Use of Longidaza in chronic prostatitis: A systematic review and meta-analysis].","authors":"S Ibishev Kh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic bacterial prostatitis (CBP) is a disease with a multifaceted pathophysiological basis, including infectious, immunological, neurological, vascular, endocrinological, biochemical, and psychological factors, making it a multidisciplinary problem. One current treatment strategy is the use of the original drug Longidaza, which has demonstrated efficacy in this disease, primarily due to its anti-inflammatory effect. A large number of original studies necessitate systematization of the results.</p><p><strong>Objective: </strong>To conduct a comprehensive assessment of the clinical efficacy of Longidaza (bovhyaluronidase azoximer) when included in the treatment plan for chronic prostatitis, based on data from controlled clinical trials.</p><p><strong>Materials and methods: </strong>A systematic review and meta-analysis were conducted according to the PRISMA protocol. Elibrary, PubMed, and Cyberleninka databases were used to search for articles. The search was conducted using a combination of keywords: chronic prostatitis and \"Longidaza,\" \"Bovhyaluronidase azoximer,\" among studies published no later than August 31, 2025.</p><p><strong>Results: </strong>A search of scientific databases using the algorithms illustrated in Figure 1 yielded a total of 210 publications, of which 10 studies were then selected based on inclusion/exclusion criteria.</p><p><strong>Conclusions: </strong>The results of the analysis suggest that adding Longidaza to standard therapy for chronic prostatitis (antimicrobial and anti-inflammatory agents) significantly reduces clinical manifestations of the disease. Furthermore, the inclusion of Longidaza in the treatment plan reduces inflammation in the prostate gland and improves maximum urinary flow rate, resulting in a significant reduction in the severity of chronic prostatitis.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 5","pages":"174-182"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R Nasirov F, T Valiev Kh, Yu Yuldashev F, I Giyasov Sh
Aim: To improve surgical outcomes in patients with benign prostatic hyperplasia (BPH) by assessing the efficacy and safety of bipolar transurethral resection of the prostate (b-TURP) in comparison with thulium laser enucleation of the prostate (ThuLEP).
Materials and methods: A retrospective and prospective analysis of surgical outcomes was performed in 555 patients with BPH who were examined and operated on between 2018 and 2024. Among them, 301 patients underwent bipolar TURP, and 254 patients underwent transurethral thulium laser enucleation of the prostate (ThuLEP). The mean age of patients was 68.8+/-8.10 years in the b-TURP group and 68.3+/-8.10 years in the ThuLEP group (p>0.05).
Results: The intraoperative blood loss and volume of removed tissue were significantly higher in the ThuLEP group. The incidence of early and late postoperative complications was significantly higher in patients after b-TURP. The need for additional postoperative pharmacotherapy and its duration due to lower urinary tract symptoms (LUTS) were also significantly greater after b-TURP.
Conclusion: Although both techniques provide a comparable and high efficacy in the surgical removal of adenomatous prostatic tissue, their safety profiles differ. Despite effective relief of bladder outlet obstruction, bipolar TURP is inferior to ThuLEP in terms of patient safety and early postoperative recovery.
{"title":"[Comparative evaluation of the efficacy and safety of surgical methods for the treatment of benign prostatic hyperplasia: bipolar TURP and ThuLEP].","authors":"R Nasirov F, T Valiev Kh, Yu Yuldashev F, I Giyasov Sh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To improve surgical outcomes in patients with benign prostatic hyperplasia (BPH) by assessing the efficacy and safety of bipolar transurethral resection of the prostate (b-TURP) in comparison with thulium laser enucleation of the prostate (ThuLEP).</p><p><strong>Materials and methods: </strong>A retrospective and prospective analysis of surgical outcomes was performed in 555 patients with BPH who were examined and operated on between 2018 and 2024. Among them, 301 patients underwent bipolar TURP, and 254 patients underwent transurethral thulium laser enucleation of the prostate (ThuLEP). The mean age of patients was 68.8+/-8.10 years in the b-TURP group and 68.3+/-8.10 years in the ThuLEP group (p>0.05).</p><p><strong>Results: </strong>The intraoperative blood loss and volume of removed tissue were significantly higher in the ThuLEP group. The incidence of early and late postoperative complications was significantly higher in patients after b-TURP. The need for additional postoperative pharmacotherapy and its duration due to lower urinary tract symptoms (LUTS) were also significantly greater after b-TURP.</p><p><strong>Conclusion: </strong>Although both techniques provide a comparable and high efficacy in the surgical removal of adenomatous prostatic tissue, their safety profiles differ. Despite effective relief of bladder outlet obstruction, bipolar TURP is inferior to ThuLEP in terms of patient safety and early postoperative recovery.</p>","PeriodicalId":23546,"journal":{"name":"Urologiia","volume":" 5","pages":"89-96"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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